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You’ve been thinking about booking for a while now. Something isn’t right, whether that’s leaking when you cough, pelvic pain that won’t settle, or a heaviness you can’t quite explain. But the idea of talking about it, let alone being examined, keeps putting you off.
You’re not unusual. Bladder and bowel control problems affect close to 4.8 million Australians, yet only about one in four people seek help. At our Fairfield and Carlton clinics, we hear the same thing from new pelvic physio clients regularly: they wish they’d come sooner.
Here’s what happens at a first appointment, step by step, so there’s nothing to wonder about.
Before you arrive
A first pelvic health consultation at Inform Physio takes about 60 minutes. That’s longer than a standard physio appointment because your physiotherapist needs time to understand your full history and do a thorough assessment.
You don’t need a referral to book. You can call (03) 9481 6312 or book online at either the Fairfield or Carlton clinic. However, if your GP sets up a chronic condition management plan (sometimes still called an EPC plan), you may be eligible for a Medicare rebate on up to five allied health sessions per calendar year. It’s worth asking your GP about this before your first appointment, as it can reduce the out-of-pocket cost.
Wear whatever is comfortable and easy to move in. Loose pants or shorts and a relaxed top work well. You don’t need to bring anything specific, but if you have referral letters, scans, or test results that relate to your condition, bring those along.
The conversation comes first
Your physio won’t jump straight into a physical assessment. They’ll start by talking with you, and this conversation usually takes around 15 to 20 minutes.
They’ll ask about your symptoms: what you’re experiencing, how long it’s been going on, what makes it better or worse, and how it affects your daily life. Depending on your situation, they may also ask about bladder and bowel habits, pregnancy and birth history, sexual function, exercise, and your goals for treatment.
These questions are personal. Your physio knows that, and they’re trained to discuss these topics without judgement. Everything is confidential and takes place in a private room. If there’s anything you’re not comfortable answering, say so. You can always come back to it at a later appointment.
The physical assessment
After the conversation, your physio may assess your posture, breathing, and how your core and pelvic floor muscles work together during movement. This might involve simple tasks like squatting, standing from a chair, or lying down while they observe how your body moves.
For many pelvic floor conditions, an internal examination gives the most accurate picture of what’s happening. This is the part most people feel nervous about, so here’s exactly what it involves.
An internal vaginal or rectal examination uses a single gloved finger to assess the pelvic floor muscles from the inside. Your physio is checking muscle tone, coordination, and strength. The assessment is done gently, lying down, and typically takes only a few minutes.
The most important thing to know: you are in control the entire time. Your physio will explain what they plan to do before they do it and will ask for your consent at every step. If you want to stop, you stop. No pressure, no judgement.
If you’d rather not have an internal assessment at your first appointment, that’s completely fine. Your physio can use other methods to begin building your treatment plan. Real-time ultrasound, for example, uses a small probe placed on your lower abdomen to show your pelvic floor muscles on a screen, with no internal contact at all.
Why the assessment matters
Pelvic floor problems aren’t always about weakness. This is one of the most important things a proper assessment reveals.
Sometimes the muscles are too tight and won’t relax properly, which can cause pain, urgency, or difficulty emptying the bladder or bowel. Sometimes the coordination is off, so the muscles contract when they should be relaxing. Sometimes there’s a combination of weakness in some areas and tension in others.
Your physio assesses strength, relaxation, coordination, and endurance to build a complete picture. This is why a generic ‘do more Kegels’ approach can fall short, or even make symptoms worse. Without knowing what’s happening, exercises might target the wrong problem.
What happens next
Once the assessment is complete, your physio will explain their findings in plain language and outline a treatment plan tailored to what they’ve found.
Treatment for pelvic floor conditions often includes targeted exercises (which may or may not include Kegels, depending on your assessment), strategies for managing bladder or bowel symptoms, breathing and relaxation techniques, and sometimes manual therapy. You’ll go home with specific exercises to practise between sessions.
Follow-up appointments are usually 30 minutes and are typically spaced one to four weeks apart, depending on your condition. Many people begin to notice improvement within four to six weeks of consistent work, though this depends on the condition and how long you’ve had symptoms. Your physio will be upfront about what to expect.
Inform Physio offers pelvic health physiotherapy for women, men, and children, which means you’re seeing a physio with specialist training in this area regardless of who the appointment is for. You can book at either the Fairfield or Carlton clinic online or by calling (03) 9481 6312. If you’re unsure whether a chronic condition management plan from your GP could reduce your costs, ask when you book and the team can walk you through it.